Fenestrated Anterior Communicating Artery Complex Mimicking an Unruptured Aneurysm: Diagnostic Pitfall

Abstract: Anatomical variations often occur in the anterior communicating artery (AComA) complex, and a careful preoperative evaluation is required before repair of this lesion. We report a case of a fenestrated AComA complex mimicking an unruptured cerebral aneurysm. A 49-year-old woman was referred to our hospital under suspicion of unruptured aneurysms of the AComA and the left middle cerebral artery on magnetic resonance angiography (MRA). Additional three-dimensional computed tomographic angiography (CTA) showed the lesion arising from the AComA complex with a maximum diameter of 4.2 mm. Intraoperative findings showed that the putative aneurysm was actually a fenestrated AComA complex as the blood vessels that formed the AComA complex were dilated and meandering. After the operation, MRA and CTA three-dimensional images were reviewed again but we could still not diagnose the lesion as a fenestrated AComA complex rather than an aneurysm. However, in the MRA source image, a secant line in the lesion was the only finding suggestive of a fenestration. The AComA complex is often associated with various vascular malformations, and it is essential to consider this association in the preoperative evaluation. The interpretation of source images may be helpful for accurate diagnosis and surgical planning.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Fenestrated Anterior Communicating Artery Complex Mimicking an Unruptured Aneurysm: Diagnostic Pitfall ; volume:18 ; number:01 ; year:2023 ; pages:201-205
Asian journal of neurosurgery ; 18, Heft 01 (2023), 201-205

Beteiligte Personen und Organisationen
Tsukada, Atsushi
Yanaka, Kiyoyuki
Takeda, Hayato
Onuma, Kuniyuki
Takada, Maya
Nakamura, Kazuhiro
Ishikawa, Eiichi

DOI
10.1055/s-0043-1764119
URN
urn:nbn:de:101:1-2023052510334554149715
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
14.08.2025, 11:01 MESZ

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Beteiligte

  • Tsukada, Atsushi
  • Yanaka, Kiyoyuki
  • Takeda, Hayato
  • Onuma, Kuniyuki
  • Takada, Maya
  • Nakamura, Kazuhiro
  • Ishikawa, Eiichi

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